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An efficient and novel treatment regimen including temozolomide for medulloblastoma: a case study

Published online by Cambridge University Press:  10 May 2021

Farshid Arbabi-Kalati ,
Ali Dadras Open the ORCID record for Ali Dadras [Opens in a new window]  and
Mohammad Nami Open the ORCID record for Mohammad Nami [Opens in a new window]
Farshid Arbabi-Kalati
Affiliation:
Department of Radiation Oncology, Roshana Cancer Institute, Tehran, Iran
Ali Dadras*
Affiliation:
Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
Mohammad Nami
Affiliation:
PGME, Harvard Medical School, Boston, MA, USA Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
*
Author for correspondence: Ali Dadras, Université de Montréal, Département de Pharmacologie et Physiologie, Laboratory of Cardiovascular Pharmacology, Pavillon Roger Gaudry, bureau T-409, Montréal, Québec, H3T 1J4, Canada. Tel: +1 514 3436111 ext. 0913. E-mail: ali.dadras@umontreal.ca
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Abstract

Background:

The central nervous system (CNS) embryonal tumour is a rare malignancy reported in adults and more commonly in children. The most available treatments may cause neurological dysfunctions requiring clinical attention.

Case presented:

A 29-year-old male was referred with ataxia and diplopia, and brain imaging revealed a posterior fossa lesion suggesting medulloblastoma. The tumour and related symptoms were notably alleviated following treatment with dexamethasone. Following the recurrence of tumour, a biopsy and pathology report, the diagnosis of desmoplastic/nodular medulloblastoma was confirmed. The patient underwent 18 fractions of 180 cGy spine and whole-brain radiation therapy (RT). In addition, 5400 cGy irradiation in 12 fractions was given to the posterior fossa together with 2 mg/m2 intravenous vincristine (VCR) weekly over 6 weeks. Following a 3-week break, the patient was scheduled to receive 150 mg/m2/day temozolomide for 5 days, 2 mg VCR and 65 mg/m2/day cisplatin every 3 weeks for 8 cycles.

Conclusion:

The patient gained survival benefit to date (60 months since diagnosis) with favourable life quality. The promising response in this one exemplary case study proposes that a combined chemotherapy regimen including temozolomide, vincristine and cisplatin is an effective treatment choice for CNS embryonal tumours following RT; however, the further evaluation and a randomised clinical trial are needed.

Keywords

temozolomidedexamethasoneCNS embryonal tumourmedulloblastomaposterior fossa
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 22 , 2023 , e4
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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